This paper could not have been written without the financial and organizational support from Dieter Paulmann and Jo Hastie respectively. Thanks are also due to 2 anonymous reviewers, whose comments on an earlier version of the manuscript greatly improved the paper. The views expressed in this paper are those of the authors alone and do not represent those of Stellwagen Bank National Marine Sanctuary, the U.S. National Marine Sanctuary Program, Southwest Fisheries Science Center, the U.S. National Marine Fisheries Service, NOAA and/or any other institution or agency. Correspondence concerning this article should be addressed to Andrew Wright, Leviathan Sciences, U.S.A. (marinebrit@gmail.com). Consequences of extreme noise exposure are obvious and usually taken into some consideration in the management of many human activities that affect either human or animal populations. However, the more subtle effects such as masking, annoyance and changes in behavior are often overlooked, especially in animals, because these subtleties can be very difficult to detect. To better understand the possible consequences of exposure to noise, this review draws from the available information on human and animal physiology and psychology, and addresses the importance of context (including physiological and psychological state resulting from any previous stressor exposure) in assessing the true meaning of behavioral responses. The current consensus is that the physiological responses to stressors of various natures are fairly stereotyped across the range of species studied. It is thus expected that exposure to noise can also lead to a physiological stress response in other species either directly or indirectly through annoyance, a secondary stressor. In fact many consequences of exposure to noise can result in a cascade of secondary stressors such as increasing the ambiguity in received signals or causing animals to leave a resourceful area, all with potential negative if not disastrous consequences. The context in which stressors are presented was found to be important not only in affecting behavioral responses, but also in affecting the physiological and psychological responses. Young animals may be particularly sensitive to stressors for a number of reasons including the sensitivity of their still-developing brains. Additionally, short exposure to stressors may result in long-term consequences. Furthermore, physiological acclimation to noise exposure cannot be determined from apparent behavioral reactions alone due to contextual influence, and negative impacts may persist or increase as a consequence of such behavioral changes. Despite the lack of information available to managers, uncertainty analysis and modeling tools can be coupled with adaptive management strategies to support decision making and continuous improvements to managing the impacts of noise on free-ranging animals.